Provider Demographics
NPI:1922849900
Name:MCGOLDRICK, MOLLY RAE (LMSW)
Entity type:Individual
Prefix:MISS
First Name:MOLLY
Middle Name:RAE
Last Name:MCGOLDRICK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 LYNNCREST DR
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2776
Mailing Address - Country:US
Mailing Address - Phone:319-930-8005
Mailing Address - Fax:
Practice Address - Street 1:1039 ARTHUR ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6665
Practice Address - Country:US
Practice Address - Phone:319-338-7884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA124600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health